A New Jersey medical provider failed to select the appropriate cause of action and party to seek recovery for unpaid medical bills. The case highlights the bumping road for NJ medical providers who seek reimbursement in claims involving extra-jurisdictional work-related accidents.
FACTS
Five workers employed in the State of New York suffered work-related injuries in NY while working for a NY employer. They were treated in a NJ hospital that obtained assignments for medical costs from the patients against the workers’ compensation carrier of the NY employer. The hospital collected its bill, except for $386,961.32, from the NY workers’ compensation insurance company.
HOLDING
While NY had a workers’ compensation medical fee schedule and an arbitration procedure for disputed bills, NJ does not. The hospital filed an action before the NJ Division of Workers’ Compensation [NJDWC] for the outstanding portion of their bills. The NJWDC claim was dismissed at the hearing level for lack of jurisdiction, and no appeal was taken, citing Williams v. Port Authority of N.Y. and N.J., 175 N.J. 82 (2003).
The hospital then filed a breach of contract action against the NY workers’ compensation insurance carrier. The NJ Superior Court dismissed, and the NJ Appellate Court [NJAD] affirmed the dismissal. The NJAD held that it lacked jurisdiction. The NJAD suggested that a breach of contract action directly against the five employees, citing D’Ascoli v. Stieh, 326 N.J. Super499 (App. Div. 1999).
Hudson Regional Hospital v. New Hampshire Insurance Company, 2023 WL 7985354 (App. Div. 2003) Decided November 16, 2023.
UNPUBLISHED OPINION. CHECK COURT RULES BEFORE CITING.
NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION
This opinion shall not “constitute precedent or be binding upon any court.” Although it is posted on the internet, this opinion is binding only on the parties in the case and its use in other cases is limited. R. 1:36-3. Superior Court of New Jersey, Appellate Division.
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Jon L. Gelman of Wayne, NJ, is the author of NJ Workers’ Compensation Law (West-Thomson-Reuters) and co-author of the national treatise Modern Workers’ Compensation Law (West-Thomson-Reuters). For over five decades, the Law Offices of Jon L Gelman 1.973.696.7900 jon@gelmans.com has been representing injured workers and their families who have suffered occupational accidents and illnesses.
Blog: Workers ' Compensation
LinkedIn: JonGelman
LinkedIn Group: Injured Workers Law & Advocacy Group
Author: "Workers' Compensation Law" West-Thomson-Reuters
Mastodon:@gelman@mstdn.social
Recommended Citation: Gelman, Jon L., Extra-territorial Medical Provider Claims, www.gelmans.com (11/18/2023), https://workers-compensation.blogspot.com/2023/11/extra-territorial-medical-provider.html
© 2023 Jon L Gelman. All rights reserved.
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